Early mortality in patients with chronic kidney disease who started emergency haemodialysis in a Peruvian population: Incidence and risk factors

Carpio, Andrea Gómez de la Torre-Del; Bocanegra-Jesús, Alejandra; Guinetti-Ortiz, Katia; Mayta‐Tristán, Percy; Valdivia-Vega, Renzo

doi:10.1016/j.nefroe.2018.06.005

Cited by 3 publications

(5 citation statements)

References 37 publications

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“…It was identified that the main factor that triggered dialysis urgency was the presence of infections in a total of 50 patients, which corresponds to 33.8% (Table 3), followed by the lack of medical treatment in 44 patients (29.7%), lack of attendance to substitutive treatment in In which they included 557 patients and identified that 59.6% entered emergency hemodialysis session due to mainly respiratory and urinary infections [22].…”

Section: Discussionmentioning

confidence: 99%

Most Frequent Cause of Dialysis Emergency and Precipitating Factor in Patients with Chronic Kidney Disease Attending the Emergency Department of HGZ 50 in San Luis Potosí, Mexico

Marroquín¹,

Ruiz²

2023

Int J Crit Care Emerg Med

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Background: Chronic kidney disease (CKD) represents a worldwide public health problem, Mexico has a prevalence of 12.2%, of which 52,000 patients are in renal replacement therapy and 80% are treated at the Mexican Social Security Institute, it is associated with early mortality with a higher incidence after 40 years of age. The literature mentions severe metabolic acidosis, severe hyperkalemia and hyperphosphatemia, water overload and uremic syndrome as frequent causes of dialysis urgency. However, the most frequent dialysis emergency in our setting has not been studied.Objective: To establish the most frequent cause of dialysis emergencies and to identify the precipitating factor in patients with chronic kidney disease admitted to the emergency department of Hospital General Zone (HGZ) 50, Mexico.Methods: Analytical and retrospective study, the sample was obtained by calculating the finite sample (Murray's formula) of patients admitted to the emergency department over a period of one year, as well as descriptive statistics (measures of trend, central, ranges, frequencies, proportions, chi-square to establish associations), SPSS software was used. Results. Data were collected from 148 patients.Results: Severe metabolic acidosis was identified as the main cause of dialysis urgency (29.1%) and the main precipitating factor was the presence of infections at any level (33.8%). Conclusion:Refractory metabolic acidosis is the main dialysis emergency in our patients, it is important to perform gasometry on admission in the ED, the main precipitating factor is the presence of infection, so initiating timely treatment and immediately requesting renal replacement therapy, as well as providing sanitary and preventive measures will have a positive impact on reducing morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Most Frequent Cause of Dialysis Emergency and Precipitating Factor in Patients with Chronic Kidney Disease Attending the Emergency Department of HGZ 50 in San Luis Potosí, Mexico

Marroquín¹,

Ruiz²

2023

Int J Crit Care Emerg Med

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“…The United States Renal Data System reported a 90-day mortality rate of 8.6%, the Canadian Organ Replacement Register 5.6%, and the European Renal Association and European Dialysis and Transplant Association registry reported a rate of 6.6% from 29 European countries [9]. A study conducted in Peru reported a 9.3% mortality rate [6].…”

Section: Discussionmentioning

confidence: 99%

“…Dialysis is the main form of kidney replacement therapy (KRT) in patients with kidney failure in sub-Saharan Africa (SSA) [1,2]. Despite the therapeutic advances in chronic dialysis, the mortality rate among patients on this treatment is eight times higher than for the general population [3] and deaths in the first 90 days after the start of dialysis contribute importantly to the overall deaths [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…Cardiovascular diseases and infections are the leading causes of hospitalisation and early mortality in patients on dialysis [10,11]. Greater age, the use of temporary catheters, female sex and nutritional status have been associated with early death [6]. In SSA, dialysis costs which are borne by patients and families are a major cause of dialysis being suspended and early mortality [12].…”

Section: Introductionmentioning

confidence: 99%

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Early mortality in patients with kidney failure starting chronic dialysis in Zambia: a retrospective cohort analysis

Banda

Bulaya²,

Mweemba³

et al. 2022

AJN

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Introduction: Dialysis is the primary kidney replacement therapy for patients with kidney failure in sub-Saharan Africa. We assessed the rates and predictors of early mortality in Zambian patients starting chronic dialysis. Methods: This retrospective study included all patients who started chronic haemodialysis (HD) or peritonealdialysis (PD) between 1 January 2017 and 31 August 2020 at the three largest public dialysis centres in Zambia. Data on clinical, laboratory and dialysis characteristics were extracted from medical records. The primary outcome of interest was the mortality rate at 90 days. Results: A total of 154 patients were included in the study; 43.5% were female and 32% were 50 years or older.The main causes of kidney failure were hypertension (59%), glomerulonephritis (10%), HIV/AIDS (10%) andunknown (8%). The mortality rate at 90 days was 12.3%. Of these, 42% were cardiovascular-related mortalities and 32% died of infection related to central venous catheters. The lymphocyte percentage of total white blood cells was lower in patients who died compared to survivors (12.7 vs 20.8%) and was an independent predictor of early mortality (OR 0.914, 95% CI 0.850–0.983; P = 0.015). Conclusions: Early mortality was high in Zambian patients starting dialysis, and a low lymphocyte percentage was a predictor of mortality.

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“…Осложнения ХГН, не поддающиеся консервативной терапии, требуют применения заместительной почечной терапии, обеспечивающей длительную поддержку остаточной функции почек у пациентов с нефросклерозом. Необходимо отметить, что диализная терапия не обладает достаточной эффективностью в увеличении продолжительности жизни [4][5][6].…”

Section: Introductionunclassified

Prediction of small-diameter arterial fibrosis in patients with hypertension and primary chronic glomerulonephritis

Левицкая

Батюшин

Бондаренко

et al. 2020

Cardiovasc Ther Prev

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Aim. To study clinical, laboratory, and morphological risk factors for small-diameter renal arterial fibrosis in patients with hypertension (HTN) and primary chronic glomerulonephritis (CGN).Material and methods. The study included 102 patients with primary CGN. The first group consisted of 62 patients with small-diameter renal arterial fibrosis according to renal biopsy; the second group included 40 patients without vascular fibrosis. All patients signed informed consent.Results. A comparative analysis revealed the most significant differences between groups 1 and 2: mean systolic blood pressure (SBP) — 131,85±17,56 mm Hg and 119,65±22,2 mm Hg, respectively (p=0,0008); mean diastolic blood pressure (DBP) — 84,11±10,7 and 79,63±9,7 mm Hg (p=0,03), respectively; peak SBP — 158,61±23,76 mm Hg and 144,25±23,56 mm Hg (p=0,002), respectively; peak DBP — 95,66±10,33 mm Hg and 90,63±10,74 mm Hg (p=0,02), respectively; HTN stage — 1,85 [1; 3] and 1,38 [1; 3] (p=0,03), respectively; HTN grade — 1,73 [1; 3] and 1,13 [1; 3] (p=0,004), respectively; left ventricular hypertrophy — 15 patients and 2 patients (p=0,006), respectively; blood urea nitrogen — 8,98±7,31 and 6,42±4,02 mmol/L (p=0,03), respectively. Significant morphological differences between first and second groups were as follows: tubulointerstitial fibrosis — 56% and 21% (p<0,001), respectively; tubulointerstitial inflamemation — 44% and 16% (p=0,002), respectively; interstitial fibrosis — 24,9±20,5% and 9,89±19,8% (p=0,001), respectively.Conclusion. The presented analysis emphasizes a significant contribution of hemodynamics in small-diameter renal arterial fibrosis in patients with HTN and CGN. It manifested by a persistent increase of SBP and involvement of target organs. Systemic hemodynamic changes are fundamental in the development of small-diameter renal arterial fibrosis in patients with HTN and primary CGN, while the isolated progression of CGN does not significantly affect the structure of small-diameter renal arteries.

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Early mortality in patients with chronic kidney disease who started emergency haemodialysis in a Peruvian population: Incidence and risk factors

Cited by 3 publications

References 37 publications

Most Frequent Cause of Dialysis Emergency and Precipitating Factor in Patients with Chronic Kidney Disease Attending the Emergency Department of HGZ 50 in San Luis Potosí, Mexico

Most Frequent Cause of Dialysis Emergency and Precipitating Factor in Patients with Chronic Kidney Disease Attending the Emergency Department of HGZ 50 in San Luis Potosí, Mexico

Early mortality in patients with kidney failure starting chronic dialysis in Zambia: a retrospective cohort analysis

Prediction of small-diameter arterial fibrosis in patients with hypertension and primary chronic glomerulonephritis

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